What is clinical endocannabinoid deficiency (CECD)?

The endocannabinoid system controls several vital biological systems in our body. Its main function is to help restore the balance of the body and keep it in optimal conditions. Some researchers believe that a faulty endocannabinoid system could be the underlying cause of health disorders such as migraines, fibromyalgia, or irritable bowel syndrome. Although this concept is not unanimously accepted by medical bodies, there is increasing research supporting the theory.

Endocannabinoid deficiency begins in the endocannabinoid system

Before analyzing the studies on clinical endocannabinoid deficiency (CECD), it is worth reviewing the role^[1] of the endocannabinoid system and its main parts. In the immune and central nervous systems of our body, the main organs and certain areas of the brain, there are receptors that are divided into two categories: CB1 and CB2. Their role is to act as access points for cannabinoids (both internal and external) to interact with the endocannabinoid system. This allows the endocannabinoid system to help the body maintain homeostasis through a series of chemical reactions. Here you can read more about the **function of the endocannabinoid system.

Endocannabinoid deficiency is based on the belief that diseases occur as a result of problems with the endocannabinoid system. This could be due to a lack of production of endocannabinoids in the body, or to the absence or abnormalities of their receptors. When the body is not able to maintain the balance of its physiological systems, diseases occur. In the cases studied so far, these diseases are often linked to the immune system.

What research supports the “endocannabinoid deficiency” theory?

Dr. Ethan Russo was the first researcher to come up with the concept of endocannabinoid deficiency. In a study^[2] published in 2004, Dr. Russo opines that cannabinoid deficiency could be the underlying cause of several disorders.

• Migraine

Migraine is a very complex disease that involves signaling between different areas of the brain and various neurochemicals. The exact cause of migraine is still not fully understood, although genetic predisposition is considered a decisive factor for its development. Dr. Russo’s study found that AEA (anandamide) is involved in serotonin production and pain modulation. High levels of serotonin are believed to contribute to the onset of migraines, which could be counteracted by a higher concentration of AEA. According to this hypothesis, a deficiency in the production of anandamide could contribute to migraines due to the lack of regulation of serotonin.

• Fibromyalgia

Fibromyalgia is a long-term chronic disorder that causes constant pain to those who suffer from it. Currently, there is no cure for this disease, and so far, traditional medicine has only been able to alleviate the symptoms. Dr. Russo’s research indicates that “the endocannabinoid system regulates nociceptive thresholds.” Nociceptors are responsible for detecting pain and transmitting the signal to the brain for processing.

The study adds that the absence of such regulation could contribute to diseases that cause chronic pain. As in the case of migraines, serotonin is believed to have an important implication in fibromyalgia, as are various cannabinoids. According to the study results, “cannabinoids have the ability to block the spinal, peripheral, and gastrointestinal mechanisms that promote the onset of pain.”

• Irritable bowel syndrome

IBS, or irritable bowel syndrome, is the latest condition that Dr. Russo’s analysis suggests could be affected by endocannabinoid deficiency. The involvement of cannabinoids in the development of IBS is believed to be similar to that of migraine and fibromyalgia. Serotonin seems to play an important role, since patients with IBS have a high level of serotonin in their blood. However, this does not occur with all forms of IBS.

The three disorders seem to respond to the hypothesis that serotonin influences their appearance. Therefore, by controlling or manipulating serotonin levels, treatments could be developed. Cannabinoids would be an essential part of these treatments due to the influence they have on certain key endocannabinoids such as anandamide.

Dr. Russo concludes that “clinical endocannabinoid deficiency could be adequately treated with cannabinoid medications.” The research also makes it clear that more studies are needed to better understand the concept of endocannabinoid deficiency.

How could CBD help combat endocannabinoid deficiency?

Although the theory of endocannabinoid deficiency is based on scientific studies, none of them outlines how it could be treated (if it were shown to be possible). The exact role that cannabinoids play has yet to be determined. Based on current research, we can formulate some hypotheses around the idea that anandamide production is essential to combat CECD-related diseases.

In the case of CBD, it has been shown to inhibit the FAAH enzyme^[3]. Fatty acid amide hydrolase (FAAH) aids in the breakdown of anandamide, and is part of the reason that AEA does not stay in the body for very long. If its mechanisms or triggers were identified, it is very possible that CBD could help treat the diseases mentioned above. CBD also directly affects certain serotonin (5-HT1A) receptors located in the brain.

If this is proven, the implications would be very important, but more research is needed.

Although the concept of endocannabinoid deficiency was raised for the first time in 2004, there are not enough studies on the subject. The characteristics of each disorder seem to indicate a link between migraines, fibromyalgia, and irritable bowel syndrome. Dr. Russo’s evidence points to a complication with certain neurotransmitter systems related to the endocannabinoid system. From the initial examination, the theory^[4] it has been expanded to include Alzheimer’s and Parkinson’s as two other diseases possibly associated with CECD.

If CECD’s existence is proven, researchers could develop targeted therapies, rather than stick to the information provided by various preclinical studies. While there may be a pattern emerging, relying on individual analytics presents several problems. Each study has its own variables, which makes the identification of conclusive results extremely difficult. The complexity of the endocannabinoid system, and the hundreds of cannabinoids that exist, make CECD research a challenging task that requires a large-scale approach. For the millions of people who suffer from chronic illnesses, such as fibromyalgia or IBS, a potential cannabinoid-based treatment could be part of the solution. But, for now, we will have to wait for more definitive results.